Supervisor Quality HEDIS Stars - Omaha
About The Position
The Supervisor Quality HEDIS Stars provides day-to-day direction to Regional Quality Coordinators supporting HEDIS and CMS Star Ratings performance across assigned markets and provider groups. The role turns regional and national quality strategy into executable workplans, assignments, and daily activities, and holds the team accountable for gap closure, documentation, and data capture targets. The Supervisor analyzes measure performance and team productivity, identifies trends and barriers, and represents regional quality operations in recurring health plan meetings. The role prepares and presents performance updates to internal leadership and health plan partners, supports HEDIS and CMS Star Ratings improvement through care-gap and data-collection activities, and ensures quality initiatives are completed accurately, consistently, and on time. It requires a self-starter who can work with limited day-to-day direction. The position follows a hybrid schedule with three days per week in the office and requires market travel of up to 20%.
Requirements
- Minimum 2 years of experience in healthcare quality, HEDIS/Stars, care-gap closure, provider engagement, or a related healthcare operations role.
- Minimum 1 year of experience in a lead, senior coordinator, or supervisory capacity, or equivalent demonstrated experience directing staff and workflows.
- Experience working with quality performance reports, gap lists, or member-level data in Excel.
- Experience communicating performance expectations and results to staff, providers, office managers, or external partners.
- Working knowledge of HEDIS, CMS Star Ratings, NCQA quality measure specifications, and gap-closure workflows.
- Ability to turn leadership direction into workplans, assignments, and measurable team activity.
- Intermediate Excel skills, including pivot tables, filtering, sorting, lookup formulas, and basic calculations.
- Ability to interpret and explain quality performance reports, including identifying trends, outliers, and gap-closure opportunities.
- Ability to supervise, coach, and motivate a remote or hybrid team, balance workloads, and follow up on performance.
- Proficiency in Microsoft Office Suite, including independently building and updating PowerPoint performance decks, and ability to learn EMR and population health platforms.
- Clear written and verbal communication skills for presenting performance information to providers, office staff, internal leadership, and health plan partners.
- Strong organizational skills and ability to manage competing priorities and deadlines in a fast-paced environment.
- Ability to work independently with limited direction, anticipate needs, take ownership, and follow through on commitments.
- High school diploma or GED.
Nice To Haves
- Experience in managed care, value-based care, or a physician practice setting.
- Familiarity with EMR systems, supplemental data collection, or chart-abstraction workflows.
- Experience participating in health plan, payer, or joint operating meetings.
- Associate’s degree in healthcare, business, or a related field, or equivalent relevant work experience.
- Bachelor’s degree in a healthcare-related field.
- Certified Professional in Healthcare Quality (CPHQ), medical assistant, coding, or similar healthcare-related certification.
Responsibilities
- Supervise Regional Quality Coordinators, including assigning workloads, scheduling, providing day-to-day direction, and coaching performance.
- Translate regional and national quality strategy into workplans, assignments, and daily team activities.
- Monitor gap-closure production and data capture by coordinator, provider group, and measure to ensure targets are met on schedule.
- Analyze performance in Excel and standard reporting tools using pivot tables, trending, rate calculations, and productivity tracking.
- Interpret results to identify trends, outliers, and barriers, and turn findings into practical next steps.
- Escalate performance risks, data discrepancies, and resource constraints to the Regional Manager of Quality with supporting details and recommended actions.
- Coordinate gap lists, chart-chase activity, and supplemental data collection across assigned provider groups to support HEDIS and CMS Star Ratings improvement.
- Ensure team reports, trackers, and documentation are accurate and completed on time to meet internal and contractual deadlines.
- Answer coordinator questions about measure specifications, documentation requirements, and workflows.
- Train and onboard new Regional Quality Coordinators and maintain job aids, standard operating procedures, and workflow documentation.
- Coordinate provider-office outreach, scheduling support, and follow-up to close open care gaps.
- Prepare performance summaries and supporting materials for provider meetings and internal leadership reviews.
- Maintain recurring PowerPoint performance decks and present results, trends, and workplan updates to internal leadership and health plan partners.
- Represent quality in recurring health plan meetings, prepare materials, document follow-up items, and complete assigned action items on schedule.
- Partner with market operations, analytics, and health plan liaisons to resolve data discrepancies and missing documentation.
- Monitor team compliance with HIPAA, PHI handling requirements, and internal quality and documentation standards.
- Perform other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
High school or GED
